These days, we are loving the opportunity to bring our dogs into the Healthy Living office during the workday. It has been amazing being able to have our best buddies along to work for both productivity and peace of mind.

Beyond Type 1 just posted a really cool article about how pets can help with T1D management - beyond the role of diabetic alert dogs. These are some of the key benefits the article cited:

Our pets can help reduce our stress. - "When stress hormone levels spike, blood glucose levels have been known to rise significantly. The decreased stress and anxiety that interaction with animals can provide can positively affect blood glucose levels as a result!"

Our pets can help prevent loneliness. - " One major cause of stress, anxiety and depression is the feeling of loneliness. Having a beloved animal that provides consistent, unconditional love is a great way to battle these feelings and avoid those blood sugar-spiking hormones that come along with it."

Our pets encourage us to exercise. - "People who own pets (and dogs in particular) on average get more day-to-day exercise than people who do not have an animal to walk and care for. Exercise is a natural way to speed up insulin absorption and lower BG levels."

Our pets help motivate self-care. - "The added responsibility that comes with pet ownership can make you more aware of the importance of your own health. Your furry friend depends on you! Out of that love, you may love yourself more."

The quotes above are directly from the Beyond Type 1 article "Can Pets Help in T1D Management?" Settle in and take some time with a fluffy friend to help prevent and relieve stress and burnout from diabetes (or any other cause!).

In November, Dexcom set up a "coffee and bagels" food truck in L.A. and Seattle but asked for a painful payment - a fingerprick. The video documenting this experiment, embedded on nomorefingerpricks.com, is a great resource for people thinking about CGM (continuous glucose monitoring)...and for anyone trying to wrap their head around the fact that countless people with diabetes prick their finger 3,000 times each year. (Try to imagine!)

Many people with Type 1 aren’t even aware that CGM is an option. The stats from a Dexcom and Beyond Type 1 nationwide survey show:

34% of people with T1D know nothing or little about CGM

80% of people with T1D still prick their fingers more than 3 times a day

96% of CGM users would recommend CGM

Some of the most appealing benefits of CGM include:

Alerts and alarms to proactively warn of dangerous highs and lows

Continuous glucose readings sent automatically

No fingerpricks for calibration or treatment decisions**From Dexcom - If your glucose alerts and readings from the G6 do not match symptoms or expectations, use a blood glucose meter to make diabetes treatment decisions.

We have also learned from our customer community and partners that many people no longer perform fingersticks at all due to the accuracy of the Dexcom G6 system. Most commercial insurances and Medicare cover CGM. Ask Healthy Living to help you get started!

Have demonstrated competence treating the mental health needs of people with diabetes

The providers listed in the directory must have either completed the ADA-APA's continuing ed program in diabetes mental health or have two or more years of experience working with people who have diabetes. Many of the doctors also offer telemedicine services - a method of receiving care from remote locations using technology. Access the provider list here.

Thanksgiving is right around the corner! Full of family traditions, Thanksgiving often involves a large, thoughtfully prepared meal. Now is a good time to create some intention about how to approach this food-focused holiday. The ADA has a Holiday Meal Planning page that could be an excellent resource for preparations. The key points are:

Think About the Timing of Your Meal

Be Physically Active

Try Healthier Versions of Your Favorite Holiday Foods

Nibble

Be Selective

Eat Smaller Portions

Eat Your Vegetables

My action plan involves being physically active ("The best way to compensate for eating a little more than usual is to be active. Start a new tradition that involves moving around away from the food."*) and nibbling ("Have foods to nibble on while you are cooking or waiting to eat. Make sure the foods you choose won't sabotage blood glucose levels before the meal."*) Be thoughtful and prepared so you can enjoy a special day with as little stress as possible.

Our hearts, thoughts, and prayers go out to the individuals and families in North Carolina and South Carolina whom have been touched by Hurricane Florence and the flooding that has followed. Although Michigan is not affected by natural disasters like hurricanes, we have plenty of other reasons to take pause and invest some time in emergency planning. Probably our greatest weather threats in this area are snowstorms, thunderstorms, tornadoes, and associated power outages.

For people living with different health challenges and conditions, there are unique precautions to be taken and plans to be made. For those living with diabetes, it is especially important to maintain a reasonable stock of supplies to last through an emergency. Additional supplies can be purchased through our retail online supply store or by calling us at 866.779.8512 (you can always discuss this with an agent when calling for an order or refill through Healthy Living).

There is a substantial connection between diabetes and heart disease. In fact, the American Heart Associationreports that if you have diabetes, your risk of developing heart disease is more than double that of the general population. To better understand how cardiovascular disease and diabetes interface in the human body, check out the video, Break It Down: Diabetes & Heart Diseaseand the associated healthline article. This video, featuring Dr. Priyanka Wali, explains the link between these two diseases and emphasizes that lifestyle changes can have a huge impact on improving health outcomes.

The main diabetes-related health characteristics that can increase the likelihood of cardiovascular disease include high blood pressure, high blood sugar, poorly managed levels of blood fats like cholesterol and triglycerides, obesity, and living a sedentary lifestyle. Dr. Wali recommends being attentive and proactive and making these seven changes to reduce the chances of developing cardiovascular disease:

I absolutely love this news that we found about Quincy. He is a male koala living at the San Diego Zoo, who has been diagnosed with type 1 diabetes. Thanks to CGM technology, his life has dramatically changed for the better.

This article explains that, “Diabetes has rarely been documented in koalas, and animal care experts do not know what may have triggered this condition in Quincy.” As part of his treatment plan, the vets at the San Diego Zoo have teamed up with Dexcom to better manage Quincy’s blood sugar levels through the application of a continuous glucose monitoring system. Quincy is using the new Dexcom G6 CGM system.

Koalas normally sleep during the day and are mainly solitary animals. This system markedly increases Quincy’s quality of life because he can avoid pricks to his ears to check his blood sugar and can be disturbed less often overall. Instead, the sensor and transmitter placed on Quincy send his blood glucose levels in real time to a smart device monitored by his caretakers. Check out a video of Quincy and his vets in action.

We hope that Quincy's story helps promote a greater awareness of CGM therapy! If you are living with type 1 or type 2 diabetes and have commercial or Medicare insurance, you may qualify to begin CGM therapy. Reach out to our team at 866.779.8512 to learn more and start the enrollment process now.

The American Diabetes Association has released new 2018 Standards of Medical Care in Diabetes. These comprehensive recommendations include the latest advances in evidence-based care, with a new focus on advanced management for people with cardiovascular disease and diabetes. The Standards of Care outline the ADA’s latest recommendations “for the diagnosis and treatment of children and adults with type 1, type 2, or gestational diabetes, strategies to improve the prevention or delay of type 2 diabetes, and therapeutic approaches that reduce complications and positively affect health outcomes.”

Important changes and updates in the 2018 edition include these topics and more:

Have you checked out Diabetes Mine? This blog helps me keep current on happenings in the diabetes world, especially around new technology for people living with diabetes. This particular article is worth checking out: Fitbit Going All In on Diabetes, Roping in Insurers. It walks us through the many investments that Fitbit is making, as well as the partnerships the company is forming, to build a stronger foundation of support for the diabetes community.

The article includes more details on each of these bullets, explaining that another interesting step that Fitbit has taken is their investment in Sano Intelligence, a company that is developing "minimally invasive" CGM technology. All of this is great news for people with diabetes, and those who support and serve them. We are excited to see how all of this will unfold!

It’s November, and this month the T1 & T2 diabetes communities join together to raise awareness about diabetes, the challenges that come with living with this condition, and the overall impact that diabetes has on millions of Americans.

Nothing can beat the freedom of summer. I am sad to say that back-to-school time is coming back around the bend. There are many resources that can help you and your kids get ready to head back to the classroom with diabetes.

One aspect of planning that is especially important for children with diabetes is the 504 Plan. According to Beyond Type 1, “A 504 Plan ensures that no student with any sort of disability is discriminated against, and is given the same education as every other student, all the while being provided a safe space to manage their condition as needed during school.”

To learn more and work on developing a 504 Plan for your child, here are some awesome resources:

In the project called DermalAbyss, the “body surface is rendered an interactive display.” In collaboration, MIT and Harvard Medical School researchers are creating tattoo ink that has biosensors to respond to changes in the body, such as blood sugar, pH, and sodium levels. The ink color shifts in response to changes in interstitial fluid.

This work could be of special interest to people with diabetes. The sensor ink changes from blue to brown as blood sugar rises, and researchers hope that one day users will be able to monitor their glucose levels and need of insulin through their own tattoo color changes.

DermalAbyss “blends advances in biotechnology with traditional methods in tattoo artistry” and is currently in the proof-of-concept change. The next challenge for the researchers will be to test the biosensor liquid in animals for adverse reactions and possible allergies. And of course the biggest goal is to make the tattoo indicators as accurate as possible, as reliable as a blood glucose test.

If you are living with type 1 or type 2 diabetes, Continuous Glucose Monitoring (CGM) can help you make more informed treatment decisions that can lead to better glycemic control. Learn more about CGM through three of our most valuable blogs from the last year.

The Medtronic MiniMed® 670G System is the world’s first hybrid closed loop insulin pump system, sometimes referred to as an artificial pancreas. The system constantly self-adjusts to automatically keep your sugar levels in range, based on how you live your everyday life. This FDA-approved system is specialized for type 1 diabetes patients, ages 14 and over, and requires a prescription. The Medtronic MiniMed® 670G System is now shipping.

2. Auto Mode – Automatically adjusts basal insulin delivery up and down every 4 minutes, based on your sugar levels, to keep you in target range, all day and night. The system can temporarily change your glucose target during athletic activity to help maintain a safe range.

3. Guardian sensor 3 continuous glucose monitoring sensor – Offers seven-day wear and easy insertion, and is the first and only CGM sensor that is FDA-approved and trusted to control insulin dosing.

Other Medtronic MiniMed® 670G System Highlights:

Glucose levels are automatically kept within range all night long for a restful, uninterrupted night’s sleep.

The system is waterproof, with a bright color screen.

At meals and snacks, only check your glucose and enter the number of carbs when you administer a bolus. The 670G system will do the math to regulate your insulin and keep glucose levels in range without any necessary insulin injections.

Speaking from Experience

Jason Gensler is a person with type 1 diabetes and the founder of the Foundation for Type One Diabetes. Jason has been wearing the Medtronic 670G for the last 2 years or so and can share these insights (in his words):

"I am experiencing very impressive results, yet I’m only testing 4-5 times per day and calibrating three times."

"I’d say the best aspect is that the system itself is so intuitive and user-friendly. It’s always one step ahead, and the sensor is incredibly accurate."

"It’s a relief! The day that it sinks in, when you realize that you’ve relinquished a majority of the control to the pump, is the day you begin to experience the freedom that so many of us haven’t had since the day we were diagnosed."

"Living with T1D is hard, and staying positive can be even harder, but I’d like to remind everyone to appreciate just how far our industry has come. The technology that has been developed in the last few years is unbelievable! Let’s all be grateful that we live in a time where technology can help us lead normal lives, and that we can’t have unrealistic expectations and find a cure yesterday."

Over a big group dinner the other night, I found out that there is a considerable amount of confusion about both what CGM is and the differences between CGM and insulin pumps. Hopefully this blog will help shed some light on these questions!

1. What information will I get from Continuous Glucose Monitoring (CGM)?

CGM measures glucose in the tissue fluid throughout the day and night, about every five minutes, and sends the collected data to a receiver, phone, or insulin pump. This information can tell you how your glucose levels are trending, so you can make better decisions about your insulin dosing.

2. How can CGM help me manage diabetes better?

A continuous glucose monitor is a small wearable device system that tracks your glucose throughout the day and night, notifying you of highs and lows so you can take action. A CGM system consists of 3 parts:

Small, under-the-skin sensor that measures glucose levels

Transmitter that attaches to the sensor and transmits data

Receiver that displays real-time glucose information

3. Are there additional benefits of CGM?

Continuous glucose monitoring can help you make the best possible decisions since you'll be able to see your trend data provided by the CGM instead of basing choices only on a number from a blood glucose meter reading. You can also set thresholds for high and low numbers, and the CGM will alert you when it senses your glucose levels have moved out of the safe range you set.

4. Is CGM covered by insurance?

Yes, CGM is covered by many insurance plans. Our Insulin Pump & CGM Therapy Team can help you obtain a prescription from your doctor, navigate the insurance verification process, and place your CGM system order. They also help customers with CGM supply refills.

5. What is the difference between CGM & insulin pumps?

Continuous glucose monitoring collects information on your blood glucose levels. This information can be used for proper insulin dosing through your insulin pump. CGM and insulin pumps can be used separately (a person can use just one or the other) or together.

From Hints to a Peek at an Apple Watch CGM

Tim Cook, CEO of Apple, told students at the University of Glasgow in February that he had been wearing a glucose tracker, and that it helped him understand the impact of different foods on his blood sugar levels. Fast-forward to April. News surfaced that Apple was developing a solution, integrated with its Apple Watch, to diagnose and manage diabetes, with a non-invasive sensor that continuously measures blood glucose levels. One month later – May. Tim Cook was spotted wearing a prototype glucose tracker that pairs with the Apple Watch around Apple’s campus.

For over five years, Apple has had a team of biomechanical engineers working on developing a continuous blood glucose sensor to pair with their Apple Watch that does not break the skin. Their Palo Alto-based research team has already begun feasibility tests with the tracker they have engineered to date. Apple calls their challenging intention of creating this technology the “holy grail” in diabetes.

"It's mentally anguishing to stick yourself many times a day to check your blood sugar," Tim Cook said, according to CNBC. "There is lots of hope out there that if someone has constant knowledge of what they're eating, they can instantly know what causes the response... and that they can adjust well before they become diabetic."

Speculation about the Tracker’s Functionality & Watch Integration

Based on the description from CNBC, it sounds like the tracker Cook is wearing is a separate, independent unit that communicates to the Apple Watch over Bluetooth, as opposed to a feature integrated inside the Watch itself. Some are hypothesizing that Apple will sell the glucose tracker as an additional accessory. This could be especially helpful since the blood monitoring feature requires approval and regulation of the FDA. If Apple sells the tracker as a separate accessory, they will be able to avoid adding regulatory procedures to the production of the entire Apple Watch.

One report indicated that Apple would manufacture smart bands that expand the Watch with additional functions, meaning the glucose monitor could become a part of one of those separate smart bands, which would communicate with the core Apple hardware.

The Apple Watch & Health Monitoring

If Apple can successfully create this next-generation glucose monitor, it will transform the Apple Watch from a wearable accessory to a revolutionary health device, beyond heart rate and activity tracking. Tim Cook recently told a group: "This is an area where I'm very excited about Apple's contribution. Very excited."

Upcoming Dexcom Integration

Dexcom is an existing, trusted leader in continuous glucose monitoring technology. Apple announced at their recent WWDC (World Wide Developer Conference) that they were releasing a Bluetooth API for their Apple Watch that would allow it to pair directly with health sensors such at Dexom CGM.

With summer quickly approaching and warm weather upon us, we might all be getting the itch to take some time off and explore someplace new and exciting. Perhaps a long weekend trip to northern Michigan, or a visit to a bustling and bright city is on the horizon for you. For those individuals living with diabetes, however, it may feel difficult and restricting to take a long and relaxing break from their everyday routine. I am here to supply you with all of the necessary tools and tricks to manage your diabetes with as little stress as possible when visiting all those exciting summer vacation destinations. Following these few tips can help you worry less and manage better while away from home, exploring our beautiful world.

The Top 5 Tips for Traveling with Diabetes This Summer

See your doctor before you head out and possibly have a medical exam to ensure your diabetes is in good control. This will give you some peace of mind while away from home.

Tip #2:

Wear a medical ID bracelet or necklace that shows that you live with diabetes. This will be helpful in case of an emergency and allows others to be aware of your medical needs. A medical ID can provide crucial information about your health condition and also list allergies in case of an emergency.

Tip #3:

The ADA recommends that you pack twice as much medication and supplies as you think you will need for the trip. Keeping your supplies in your carry-on bag is important because checked luggage can potentially be lost (if you are flying), and this ensures your medication and supplies are with you at all times. Allow for extra time at the airport because security might take additional time with your insulin pump.

When traveling with insulin, especially if you are traveling by bike or car, you may have to take a few extra steps to keep it at the right temperature. Insulin does not need to be refrigerated, however if you store insulin in places that are too hot or too cold, its effects may be disrupted. Storing insulin in the glove box or somewhere in your car may not be the best option because of potential extreme temperatures. If you are traveling by car, bike, or you are out exploring in hot conditions, try using travel packs to keep your insulin cool. The insulin protector from the HLMS online store may be helpful when carrying insulin for your summer adventures!

Tip #5:

Go check out Beyond Type One’s travel webpage, which will provide you with various stories and tips from people living with diabetes who have traveled the world.

Bonus tip!

Do not let diabetes hold you back from enjoying yourself, great adventure, and good company while you’re on vacation. After all it is called “vacation” for a reason, and it’s made for relaxation!

Curcumin, which is found in the spice turmeric, has been found to help control blood sugar, improve insulin sensitivity, reduce diabetes-related complications, and even prevent diabetes. Check out this article to learn about turmeric, a potential positive addition to your existing diabetes management plan.

What is V-Go?

V-Go is a wearable insulin delivery device for adults with Type 2 diabetes who take long-acting insulin, want to reduce their need for injections, and are working to improve glycemic control.

How V-Go Works

The main job of insulin is to control sugar in your bloodstream and keep it within a normal range. However, if you have Type 2 diabetes, your body may not release enough insulin during the day or at mealtimes, which can result in your blood sugar being too high. V-Go provides a steady rate of insulin 24 hours a day (basal) and allows you to give yourself a dose of insulin during snacks and mealtimes (bolus).

V-Go ‘CliffsNotes’

In a short summary, the V-Go:

Is wearable & disposable

Provides insulin at a steady rate, 24 hours a day

Gives supplemental insulin delivery at meal and snack times when the patient clicks their device

Eliminates the need for multiple daily injections

Needs to be replaced every 24 hours with a new, insulin-filled, V-Go device

Uses rapid-onset insulin, either Humalog of Novolog, which the user loads into the device

V-Go from Healthy Living

Although the V-Go is not widely used yet, it can be a positive alternative to multiple daily injections, and Healthy Living can verify your insurance and provide these devices. If you are an adult with type 2 diabetes, talk with your doctor and see if V-Go could be a good fit for you. It’s another good option for managing your diabetes!

Overview of Simple Steps for Using V-Go

Fill with insulin

Apply to body (can be in a discreet place)

Start steady-stream insulin delivery to continue throughout wear-time

Click the V-Go to administer more insulin at snack and mealtimes

Shower and sleep in your V-Go

After 24 hours, dispose of your V-Go and start using a new one

Apply it to a new site and have a great day!

See the official Patient Start Guide from V-Go for more detailed information for set-up and use.

You Know What They Say – Be Prepared

A passionate diabetes advocate, Kelly Kunik wrote the very thoughtful post ‘Taking Your Diabetes to Work’ on the Mango Health blog this February. She talks about the importance of being ready for anything and makes great suggestions, like doing blood sugar checks before you hit the road to and from work. Kelly also gives tips about some of the best ways to communicate (addressing who, when, and how?) about living with diabetes with coworkers and supervisors.

Some other subjects that Kelly covers include:

· Understanding your rights in the workplace

· Prepping for meetings and presentations

· Having a designated “d drawer” with snacks and go-tos for times of low blood sugar

· Preparing for commutes

About the Author

Kelly Kunik has lived with type 1 diabetes since she was eight years old. Her greatest perceived weakness (a busted pancreas) has become her greatest strength and biggest passion. Kelly is a diabetes advocate that authors the blog, Diabetesaliciousness. She’s also a writer, speaker, consultant, and creator of the #IWishPeopleKnewThatDiabetes initiative. You can find Kelly on Twitter @diabetesalish.